Healthcare Provider Details

I. General information

NPI: 1306432943
Provider Name (Legal Business Name): KERI HOYE YANCEY PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN ST
BLACKSTONE VA
23824-1424
US

IV. Provider business mailing address

100 N MAIN ST
BLACKSTONE VA
23824-1424
US

V. Phone/Fax

Practice location:
  • Phone: 434-292-3132
  • Fax: 434-292-6467
Mailing address:
  • Phone: 434-292-3132
  • Fax: 434-292-6467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202206946
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: